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ACCME ponders naming and shaming

The ACCME said it will consider releasing names of providers and activities found to violate bias rules. The exact details of the disclosure, if any, and the timing are under review by the ACCME Board of Directors, which meets December 3-4.

ACCME executive director Dr. Murray Kopelow told The New York Times in October that, “within weeks,” the group would publicly disclose a “previously confidential” listing of the names of classes and companies found to be in violation of rules against commercial bias.

This disclosure policy “is still with the board of directors,” Kopelow told MM&M. “The next steps have to do with their due diligence.”

He said he wants to assure providers that before ACCME acts to implement any next steps with regard to transparency, “all the plans will be fully vetted by the board of directors,” which he said has “the last and final word on the approval of the mechanism for release and the manner in which [information] is presented.”

“As always,” he added, “providers will be fully informed.” Earlier this year, ACCME signaled its intent by saying the group reserves the right to make such information public. The change appears in an amendment to a policy for dealing with complaints and inquiries about activities.

Information for the disclosure would come from these complaints and inquiries, which are initiated by private individuals, not from the three reaccreditation reviews the group conducts each year to assess the accreditation status of some 200 providers.

Another proposal on the agenda for the December meeting would clarify providers' responsibilities to learners whenever it is later found that class material was biased in favor of a drug firm, he said.

A range of options are on the table, from notifying doctors to providing clarifying information and possibly revoking learner credits.

This would entail a new level of enforcement. “In the past, some providers have voluntarily reported to ACCME that they felt that one of their activities was not in compliance with ACCME's requirements, because of bias perhaps, and they wanted to know if they could inform the learners or transmit corrections,” Kopelow said. “We have said to providers: ‘Yes, go ahead and give [physicians] the clarifying information if you would like to.' But we have never made it a requirement.”

Both potential policy changes would be in addition to information ACCME released in August about specific accredited providers, their accreditation status and whether or not they accept commercial support. Those findings are now posted on the group's website.

“ACCME has demonstrated a commitment to meaningful and important transparency,” Kopelow said. “We acted in 2009 to enhance the information we made public about providers, as we had announced we would.”

He also clarified that ACCME has a formal policy for providers to respond to allegations made in the complaints and inquiries process. The ACCME Reconsideration and Appeals process applies only after an adverse action is taken by ACCME, such as when a provider's accreditation status is changed.

Prior to any adverse action, during the normal “activity review” phase, he said, ACCME presents the complaint or inquiry to the organization, and the program has a chance to demonstrate how the activity complies. “In my 15 years of experience, most providers implement improvements in their Programs as a result of a complaint or inquiry.”

This “improvement model” is the basis for the accreditation review process and the complaint/inquiry process, he said.

“We believe strongly in due process,” Kopelow added. “We expect that the complaints and inquiries process is sufficiently back-and-forth between the ACCME and provider so as to create the opportunity for the provider to explain itself.”

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